<div class="infoBlock infoBlockM infoBlockA">
<div class="infoBlockHeading"><span class="t">Basic Information</span>
<span class="ps">
<a href="{$CONTEXT.URL}">Home</a> > 
<a href="{$CONTEXT.MEMBERURL}">Member</a> > 
<a href="{$CONTEXT.MEMBERURL}status" class="st">Status</a>
</span>
</div>
<div class="infoBlockContent">

{literal}
<style type="text/css">
input.inputText1 {
	width: 80px;
}
input.underlineText {

}
ul.mchls {
	list-style: none;
	padding: 0px;
	margin: 0px;
}
ul.mchls li {
	float: left;
	width: 80px;
}
</style>
<script type="text/javascript" language="javascript">
function mc_chk_one(obj){
	var form = obj.form;
	var as = form.getElementsByTagName("INPUT");
	for(var i=0; i<as.length; i++){
		if(as[i].type && as[i].type.toLowerCase()=="checkbox"){
			if(as[i].name && as[i].name == obj.name && as[i].value != obj.value){
				as[i].checked = false;
			}
		}
	}
}
</script>
{/literal}

<div class="infoBlockItem">
<form name="statuseditform" method="post">
<input type="hidden" name="action" value="updatestatus">
<input type="hidden" name="type" value="basic">
<table width="100%" border="0" cellspacing="0" cellpadding="5" class="editBox editBoxB">
  <tr>
    <td width="20%" rowspan="4">請將學員照片粘貼此處</td>
    <td colspan="3">出生姓名 {pp_inputtext name="field_bs_name" value=$CONTENT.item.bs_name class="inputText2 underlineText"}</td>
    <td colspan="3">出生國家身份證號碼 {pp_inputtext name="field_bs_number" value=$CONTENT.item.bs_number class="inputText1 underlineText"}</td>
  </tr>
  <tr>
    <td colspan="3">英文名 {pp_inputtext name="field_fs_name" value=$CONTENT.item.fs_name class="inputText2 underlineText"}</td>
    <td colspan="3">生日 月/日/年 {pp_inputtext name="field_fs_birthday" value=$CONTENT.item.fs_birthday class="inputText1 underlineText"}</td>
  </tr>
  <tr>
    <td colspan="3">護照姓名 {pp_inputtext name="field_st_passport" value=$CONTENT.item.st_passport class="inputText1 underlineText"}</td>
    <td colspan="3">性別 {pp_inputcheckbox name="field_st_gender" value="1" checked=$CONTENT.item.st_gender output="男" onclick="mc_chk_one(this);"} / 
    {pp_inputcheckbox name="field_st_gender" value="2" checked=$CONTENT.item.st_gender output="女" onclick="mc_chk_one(this);"}</td>
  </tr>
  <tr>
    <td width="10%">身高</td>
    <td width="10%">{pp_inputtext name="field_st_height" value=$CONTENT.item.st_height class="inputText1 underlineText"}</td>
    <td width="10%">體重</td>
    <td width="10%">{pp_inputtext name="field_st_weight" value=$CONTENT.item.st_weight class="inputText1 underlineText"}</td>
    <td width="10%">髮色</td>
    <td width="10%">{pp_inputtext name="field_st_haircolor" value=$CONTENT.item.st_haircolor class="inputText1 underlineText"}</td>
  </tr>
</table>

<table width="100%" border="0" cellspacing="0" cellpadding="5" class="editBox editBoxB">
  <tr>
    <td width="20%" rowspan="2">國內聯絡人</td>
    <td width="10%">父親</td>
    <td>{pp_inputtext name="field_dc_father" value=$CONTENT.item.dc_father class="inputText1 underlineText"}</td>
    <td width="12%">住宅電話</td>
    <td>{pp_inputtext name="field_dc_homephone" value=$CONTENT.item.dc_homephone class="inputText1 underlineText"}</td>
    <td width="10%">傳真</td>
    <td>{pp_inputtext name="field_dc_fax" value=$CONTENT.item.dc_fax class="inputText1 underlineText"}</td>
  </tr>
  <tr>
    <td>母親</td>
    <td>{pp_inputtext name="field_dc_mother" value=$CONTENT.item.dc_mother class="inputText1 underlineText"}</td>
    <td>公司電話</td>
    <td>{pp_inputtext name="field_dc_compphone" value=$CONTENT.item.dc_compphone class="inputText1 underlineText"}</td>
    <td>手機</td>
    <td>{pp_inputtext name="field_dc_mobile" value=$CONTENT.item.dc_mobile class="inputText1 underlineText"}</td>
  </tr>
  <tr>
    <td>家庭住址</td>
    <td colspan="2">{pp_inputtext name="field_dc_address" value=$CONTENT.item.dc_address class="inputText2 underlineText"}</td>
    <td>電子郵件地址</td>
    <td colspan="3">{pp_inputtext name="field_dc_email" value=$CONTENT.item.dc_email class="inputText2 underlineText"}</td>
  </tr>
</table>

<table width="100%" border="0" cellspacing="0" cellpadding="5" class="editBox editBoxB">
  <tr>
    <td width="20%" rowspan="2">美國聯絡人</td>
    <td width="10%">姓名</td>
    <td>{pp_inputtext name="field_fc_name" value=$CONTENT.item.fc_name class="inputText1 underlineText"}</td>
    <td width="12%">住宅電話</td>
    <td>{pp_inputtext name="field_fc_homephone" value=$CONTENT.item.fc_homephone class="inputText1 underlineText"}</td>
    <td width="10%">傳真</td>
    <td>{pp_inputtext name="field_fc_fax" value=$CONTENT.item.fc_fax class="inputText1 underlineText"}</td>
  </tr>
  <tr>
    <td>關係</td>
    <td>{pp_inputtext name="field_fc_relation" value=$CONTENT.item.fc_relation class="inputText1 underlineText"}</td>
    <td>公司電話</td>
    <td>{pp_inputtext name="field_fc_compphone" value=$CONTENT.item.fc_compphone class="inputText1 underlineText"}</td>
    <td>手機</td>
    <td>{pp_inputtext name="field_fc_mobile" value=$CONTENT.item.fc_mobile class="inputText1 underlineText"}</td>
  </tr>
  <tr>
    <td>住址</td>
    <td colspan="2">{pp_inputtext name="field_fc_address" value=$CONTENT.item.fc_address class="inputText2 underlineText"}</td>
    <td>電子郵件地址</td>
    <td colspan="3">{pp_inputtext name="field_fc_email" value=$CONTENT.item.fc_email class="inputText2 underlineText"}</td>
  </tr>
</table>

<table width="100%" border="0" cellspacing="0" cellpadding="5" class="editBox editBoxB">
  <tr>
    <td width="20%">仲介人 / 仲介公司</td>
    <td>{pp_inputtext name="field_bc_contact" value=$CONTENT.item.bc_contact class="inputText1 underlineText"}</td>
    <td>{pp_inputtext name="field_bc_company" value=$CONTENT.item.bc_company class="inputText1 underlineText"}</td>
    <td width="12%">公司電話</td>
    <td>{pp_inputtext name="field_bc_telephone" value=$CONTENT.item.bc_telephone class="inputText1 underlineText"}</td>
    <td width="10%">傳真</td>
    <td>{pp_inputtext name="field_bc_fax" value=$CONTENT.item.bc_fax class="inputText1 underlineText"}</td>
  </tr>
  <tr>
    <td>公司住址</td>
    <td colspan="2">{pp_inputtext name="field_bc_address" value=$CONTENT.item.bc_address class="inputText2 underlineText"}</td>
    <td>電子郵件地址</td>
    <td colspan="3">{pp_inputtext name="field_bc_email" value=$CONTENT.item.bc_email class="inputText1 underlineText"}</td>
  </tr>
</table>

<table width="100%" border="0" cellspacing="0" cellpadding="5" class="editBox editBoxB">
  <tr>
    <td width="20%">學校名稱/州</td>
    <td>{pp_inputtext name="field_sch_name" value=$CONTENT.item.sch_name class="inputText1 underlineText"}</td>
    <td width="5%">{pp_inputtext name="field_sch_state" value=$CONTENT.item.sch_state class="inputText1 underlineText"}</td>
    <td width="12%">電話</td>
    <td>{pp_inputtext name="field_sch_telephone" value=$CONTENT.item.sch_telephone class="inputText1 underlineText"}</td>
    <td width="10%">學生證號碼</td>
    <td>{pp_inputtext name="field_sch_number" value=$CONTENT.item.sch_number class="inputText1 underlineText"}</td>
  </tr>
  <tr>
    <td>學校聯絡人</td>
    <td colspan="2">{pp_inputtext name="field_sch_contact" value=$CONTENT.item.sch_contact class="inputText2 underlineText"}</td>
    <td>學校地址</td>
    <td colspan="3">{pp_inputtext name="field_sch_address" value=$CONTENT.item.sch_address class="inputText2 underlineText"}</td>
  </tr>
</table>

<table width="100%" border="0" cellspacing="0" cellpadding="5" class="editBox editBoxB">
  <tr>
    <td width="20%" rowspan="2">請提供您目前的健康狀況， 對任何需要用藥之病症，請附上醫生資料以利查核。</td>
    <td height="150">氣喘 ? 食物過敏 ? 藥物過敏 ? 皮膚過敏 ? 其他藥物相關問題 / 狀況<br />說明 : <br />
    <textarea name="field_comment" cols="60" rows="5"></textarea>
    </td>
  </tr>
  <tr>
    <td>*如您有任何特殊疾病或藥物過敏，請附上醫生證明, 包含旅遊許可證明。</td>
  </tr>
</table>

<table width="100%" border="0" cellspacing="0" cellpadding="5" class="editBox editBoxB">
  <tr class="editBoxHeading">
    <td colspan="2"><input type="submit" name="submitbtn" class="sbm" value="確定"></td>
  </tr>
</table>
</form>
</div>

</div>
</div>